UQ works to Close the Gap with physio placements

Healthcare practitioners know all too well about the significant gaps
in health outcomes between Aboriginal and Torres Strait Islanders
and other groups. A major issue the Close The Gap campaign has
identified is the lack of culturally safe healthcare services, a problem
that is compounded by an under-representation of Aboriginal and
Torres Strait Islanders in healthcare professions.

While closing that particular gap could take one to two decades, the
ability of non-Indigenous healthcare providers to deliver services in
a culturally appropriate way is an achievable solution in the short-term,
something that many institutions, including UQ,
have recognised.

The university’s Faculty of Health and Behavioural Sciences has
spent several years building relationships with Aboriginal and
Torres Strait Islander communities and, as of two years ago,
began partnering with these communities to offer placements for
physiotherapy students. Ruth Dunwoodie, APAM, Clinical Education
Liaison Manager, and Amy Fagan, APAM, Clinical Operations
Manager at UQ Health and Rehabilitation Clinics, play a key role in
coordinating the placements.

‘We started off by asking the Indigenous health communities what
the barriers were to engaging with physiotherapy and listening to
what their needs were,’ Amy Fagan explains.

This simple act of having open conversations is perhaps one of
the key aspects to addressing health inequalities. In 2016, the
Close The Gap Parliamentary Report stated that the government’s
priorities must include meaningful partnerships between Aboriginal
and Torres Strait Islander and non-Indigenous communities and
health services. The call to do things with Aboriginal and Torres
Strait Islanders, rather than to them, is one that’s often made when
progress towards equality is discussed.

As a result of UQ devoting the time to build strong and trusting
relationships with health services, education providers and key
community figures, they’ve been able to establish five-week
placements for physiotherapy students at organisations working closely with Aboriginal and Torres Strait Islanders. There, they support
the delivery of physiotherapy services to clients ranging from children
to older adults under the supervision of clinical educators.

Host services benefit from a much-needed additional practitioner,
while their clients gain a stronger awareness of physiotherapy
treatments and, hopefully, positive experiences that will encourage
them to access physiotherapy services in the future.

Students themselves undergo a significant learning curve as
they build skills in communicating across cultures, altering
service delivery to meet client needs, and thinking more laterally.
Essentially, the experience prepares them for the needs of today’s
healthcare consumer.

The cornerstone to the success of these placements in Ruth and
Amy’s eyes has been the university’s willingness to commit to
closing the gap over the long term. UQ has a pro-vice chancellor
who oversees Aboriginal and Torres Strait Islander engagement,
one of a handful of Australian universities with such a role.

The university’s current strategic plan has a specific focus on
learning, discovery and engagement among and with Aboriginal
and Torres Strait Islander communities, with the aim of providing
all students with ‘inclusive perspectives’ in a ‘culturally embracing
environment’.
The Faculty of Health and Behavioural Sciences, which includes
psychology, occupational therapy, nutrition sciences and others in
addition to physiotherapy, has focused on developing relationships
with the community to design specific interventions that can
contribute to better health outcomes.

For physiotherapy students, this has ranged from service
provision in internal UQ clinics, providing field-side support at an
Aboriginal and Torres Strait Islander community sports carnival,
and delivering outreach services at schools and communitycontrolled
health centres.

‘A lot of that work was reciprocal and ongoing for extended periods of
time in order for us to get to where we are right now,’ Amy reflects.

Equally important is the preparation students undergo well
before they’re even considering their clinical placements. Cultural
awareness is introduced early in the curriculum, with first-year
subjects that discuss cultural diversity and the application of
different theories or techniques when working with different
populations.

By third year, students are hearing from Aboriginal and Torres Strait
Islander people directly in a series of lectures, tutorials and case
studies on health in these communities.

‘They get really inspired by those sessions,’ Ruth says. ‘Around the
same time, they nominate where they’d potentially like to undertake
placements, and often they’ll come to me and say, “We had a really
awesome experience when we did the Indigenous learning and I’d
love to be placed in that area”.’

Students must first express an interest in working with this
population to be considered for one of the placements. Those
who are successful undergo a significant orientation period with
their host organisation which is then followed up with opportunities
throughout their placement to meet with key community members.

Together, these focal points help to address potential challenges
students might experience in working with this population group for
the first time.

A major barrier to overcome is being accepted by a particular
community.

‘You can’t just come and go with Indigenous communities.
You have to be respected as someone and welcomed into that
community. It can take a while to build relationships with the
elders, the key personnel within the organisation, but also with the
recipients of healthcare within the community,’ Ruth explains.

However, her regular liaison with the clinical educators in the field,
coupled with feedback from hosts and students, indicates that the
program is going well and likely has a bright future.

‘Once everything goes well with one provider and the community
embraces the student presence, that provider can commit to
having students with them and we can begin to expand on those
opportunities,’ Ruth says.

Now, the university is seeking more partners to accommodate the
high level of interest from their students in these placements. Amy
encourages any services that have reservations about hosting
student placements to put those concerns aside, as the clinical
educator liaison roles at UQ take a highly supportive approach to
building the clinical educators’ capabilities in each facility.

‘Students want to work in this space. If your practice or organisation
even has a small amount of contact with Indigenous people, there
are opportunities to be a clinical educator.’

With major Close the Gap targets—such as eliminating the
difference in life expectancy—due to be met in 2030, these
graduates will be part of the push to keep these goals at the
forefront of healthcare planning.

‘The students value that they can have a greater input into
Indigenous health. They keep bringing back to the table in
conversations with the academics and clinical placement teams
that they would like to engage with more of these opportunities as
much as they can,’ Amy says.

Queensland Branch Council recently welcomed members to the 2016 QLD Branch Members’ Dinner and Professional Excellence Awards. An evening of networking, entertainment and celebration was enjoyed by all attendees.